Abstract：
:The active management of laboratory test utilization appears to be a practical approach to addressing the financial pressures imposed by managed care and capitated reimbursement, and can complement efforts already underway in most laboratories to reduce the unit cost of testing. Managing laboratory utilization takes time that is often in short supply; however, the literature suggests that the savings from a well-focused effort can easily exceed the costs of a utilization management program. Individuals and institutions that commit themselves to active utilization management need to realize (1) how laboratory utilization is measured, (2) benchmarks within the industry, and (3) the stubborn structural and psychological constraints that are likely to limit progress. Some approaches to reducing utilization, such as education, have poor track records and are best avoided. Other avenues, such as providing financial feedback and making specific changes to the environment in which tests are ordered, have demonstrated moderate success in the past and hold considerably more promise.
journal_name
Clin Lab Medjournal_title
Clinics in laboratory medicineauthors
Valenstein Psubject
Has Abstractpub_date
1996-09-01 00:00:00pages
749-71issue
3eissn
0272-2712issn
1557-9832journal_volume
16pub_type
杂志文章abstract：:The last decade has witnessed the transformation of first-trimester Down syndrome screening from an aspiration to a clinical reality. First-trimester screening now equals or exceeds the diagnostic accuracy of conventional midtrimester screen while realizing an important desire of pregnant women for early diagnosis. Be...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2010.05.001
更新日期：2010-09-01 00:00:00
abstract：:This article addresses several fundamental features of clinical flow cytometry. A practical overview of the technical and methodologic aspects of this fast-growing and increasingly important new clinical and investigative field is provided. The use of flow cytometry for the diagnosis and monitoring of various chronic ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-06-01 00:00:00
abstract：:This article reviews the concept of dysplasia and the distinguishing features of dysplastic nevi, including their premalignant potential, their biologic markers of tumor progression, and their reproducibly recognizable clinical and histologic characteristics. An additional emphasis is placed on describing gray zone m...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：2000-12-01 00:00:00
abstract：:This article focuses on current clinical laboratory testing to diagnose Alzheimer disease and monitor its progression throughout its disease course. Several clinically available tests focus on analysis of amyloid and tau levels in cerebrospinal fluid as well as autosomal dominant and risk factor genes. Although the cu...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2020.05.003
更新日期：2020-09-01 00:00:00
abstract：:Shiga toxin-producing Escherichia coli (STEC) are important enteric pathogens worldwide, causing diarrhea with or without blood visibly present and hemolytic uremic syndrome. STEC are unique among diarrheogenic E coli in producing Shiga toxin type 1 and type 2, the virulence factors responsible for bloody diarrhea and...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2009.11.001
更新日期：2010-03-01 00:00:00
abstract：:Diabetes mellitus affects almost 16 million Americans. It has become a major public health problem and the number one cause of adult blindness, end-stage renal disease, and nontraumatic amputations in the United States. It also markedly increases the risk for cardiovascular, cerebrovascular, and peripheral artery dise...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：2001-03-01 00:00:00
abstract：:Laboratory informatics is the application of computers and information systems to information management in the pathology laboratory. Effective information management is crucial to the success of pathologists and laboratorians. Informatics has become one of the key pillars of pathology, and the requirement for skilled...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2007.07.011
更新日期：2007-12-01 00:00:00
abstract：:This study examines the relationship between D-dimer concentration and patient age, gender, race, and renal function, and the role of D-dimer concentration as a predictor of in-hospital mortality, in a critically ill patient population. The results demonstrate there is a correlation between increased D-dimer concentra...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2014.06.015
更新日期：2014-09-01 00:00:00
abstract：:This study uses three unique data sets to show the state of the art of hemoglobin A1c (HbA1c) analyzers in a range of settings and compares their performance against the international guidance set by the International Federation of Clinical Chemistry and Laboratory Medicine task force for HbA1c standardization. The da...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.09.006
更新日期：2017-03-01 00:00:00
abstract：:One of the most vital functions of the vertebrates is to maintain hemostasis through coagulation and fibrinolysis. This is achieved by the interaction of vascular walls with blood components such as cells and proteins (coagulation factors, immunoglobulins, and complement). Deficiency of coagulation factors results in ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1986-03-01 00:00:00
abstract：:This article reviews cytomorphology of rare malignant tumors of the breast: squamous carcinoma, metaplastic carcinoma, adenoid cystic carcinoma, apocrine carcinoma, secretory carcinoma, lipid-rich carcinoma, and carcinoma with choriocarcinomatous features. It is important to bear in mind the cytomorphology and diagnos...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2005.08.004
更新日期：2005-12-01 00:00:00
abstract：:Noninvasive genomic assessments of the fetus while in utero have been made possible by the analysis of cell-free fetal DNA fragments from the serum of pregnant women, as part of a noninvasive prenatal testing screening strategy. Between 7% and 10% of total cell-free DNA in the maternal blood comes from placental troph...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.01.018
更新日期：2016-06-01 00:00:00
abstract：:The search for clinical outcomes associated with antiphospholipid antibodies (aPL) has been ongoing for a decade. This article focuses on the clinical use of tests for the detection of aPL. A review of the current thinking regarding the pathophysiology of antiphospholipid syndromes is relevant to the discussion of dif...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1995-03-01 00:00:00
abstract：:Pet guinea pigs are presented to veterinary clinics for routine care and treatment of clinical diseases. In addition to obtaining clinical history and exam findings, diagnostic testing may be required, including hematological assessments. This article describes common blood collection methods, including venipuncture s...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2015.05.012
更新日期：2015-09-01 00:00:00
abstract：:The recent development and clinical implementation of genomic microarrays has resulted in rapid and significant changes for postnatal studies in the field of cytogenetics. This article discusses the benefits and issues for the use of microarrays for prenatal genetic diagnosis. It includes sections on specimen processi...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2011.08.004
更新日期：2011-12-01 00:00:00
abstract：:Biochemical prenatal screening was initiated with the use of maternal serum alpha fetoprotein to screen for open neural tube defects. Screening now includes multiple marker and sequential screening protocols involving serum and ultrasound markers to screen for aneuploidy. Recently cell-free DNA screening for aneuploid...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.01.004
更新日期：2016-06-01 00:00:00
abstract：:Lipoprotein-associated phospholipase A2 (LP-PLA2) is an emerging inflammatory marker that is used to assess the risk for cardiovascular disease (CVD) and associated events. Several epidemiologic studies have demonstrated an independent association between plasma Lp-PLA2 concentration and risk for cardiovascular events...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2006.06.003
更新日期：2006-09-01 00:00:00
abstract：:The development of assay techniques for the analysis of tumor markers in tissue extracts and in the peripheral circulation has had a major impact on the diagnosis and management of patients with endocrine neoplasms. In addition to eutopic and ectopic hormones, a variety of other tumor-derived products, including endoc...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：:The myelodysplastic syndromes are bone marrow stem cell disorders that result in disorderly and ineffective hematopoiesis. They are prognostically heterogenous. Approximately one third of cases evolve to acute myeloid leukemia. Many additional cases terminate in severe bone marrow failure. The French-American-British ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1990-12-01 00:00:00
abstract：:Electron microscopy offers substantial aid in the diagnosis of gastrointestinal tract tumors, especially small-cell carcinoma and enterochromaffin-cell tumors. Tumors that are most difficult to classify by light microscopy--that is, poorly differentiated ones--may also have ultrastructural features by which the cell o...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:Lymphoma in dogs is a heterogeneous cancer with highly variable prognosis. Many types of canine lymphoma have similar counterparts in the World Health Organization classification of human lymphoid tumors. The most common variant of canine lymphoma is diffuse large B-cell lymphoma, which, if treated with multiagent che...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章
doi：10.1016/j.cll.2010.10.001
更新日期：2011-03-01 00:00:00
abstract：:I have reviewed many of the methods available for the assessment of fetal lung maturity. The difficulty of using diagnostic tests for diseases of low prevalence has been discussed. By reviewing the nature of the amniotic fluid surfactant material, and some of the principles underlying analytical methods, the bases of ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:The coccidians Cryptosporidium spp, Cyclospora cayetanensis, and Cystoisospora belli and the flagellate Giardia duodenalis are pathogenic protozoa associated with gastrointestinal manifestations. Diagnosis relies heavily on microscopy, and although ova-and-parasite examinations can detect Giardia and Cystoisospora, Cr...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2015.02.010
更新日期：2015-06-01 00:00:00
abstract：:Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasosep...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2016.07.012
更新日期：2016-12-01 00:00:00
abstract：:Diagnostic procedures for the detection of malaria differ considerably depending on the aims of evaluation. The current requirements of any laboratory procedure for general application to the detection and diagnosis of malaria include: sensitivity, specificity, simplicity in application, unambiguous interpretation, an...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-12-01 00:00:00
abstract：:Diseases due to nontuberculous mycobacteria are increasing in frequency, especially in patients with compromised immunity. A number of "new" mycobacterial species have been described in the last decade, largely as the result of the use of new tools to identify previously unrecognized mycobacteria found in the environm...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2004.05.011
更新日期：2004-09-01 00:00:00
abstract：:The cause of colorectal cancer (CRC) is multifactorial, with genetic, molecular, inflammatory, and environmental risk factors. Recently, the gut microbiota has been recognized as a new environmental contributor to CRC in both animal models and human studies. An additional interplay of the gut microbiome with inflammat...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2014.08.002
更新日期：2014-12-01 00:00:00
abstract：:During the past 20 years, laboratory systems have evolved to a high degree of complexity. In some cases, continuing addition of new features has adversely affected functionality. There is increasing recognition that the number of features listed on a request for proposal does not necessarily provide an accurate guide ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：1991-03-01 00:00:00
abstract：:Point-of-care testing is an emerging specialty in laboratory medicine and has attracted considerable interest in the medical literature. This article presents a general overview of point-of-care testing including its history, menu, clinical utility, aspects of analytical performance, regulatory issues, and management ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：
更新日期：2001-06-01 00:00:00
abstract：:This article reviews congenital melanocytic nevi (CMN), which are present at birth or appear shortly thereafter, and their main histologic features. Several histologic variants and histopathologic criteria that differentiate CMN from other nevi, such as atypical or dysplastic nevi, and from nevoid malignant melanoma, ...
journal_title：Clinics in laboratory medicine
pub_type： 杂志文章,评审
doi：10.1016/j.cll.2011.03.004
更新日期：2011-06-01 00:00:00
